Penrose Physical Therapy
02
Jan 2016
Jennifer Penrose
Author
Jennifer Penrose

PHASE I (0-2 WEEKS):

Goals:

  • Control inflammation
  • Minimize effects of immobilization
  • Protect graft fixation
  • Achieve full extension
  • Achieve 90° flexion
  • WBAT

Exercises:

  • Heel slides/wall slides
  • Quad sets
  • Hamstring sets
  • Patellar mobilization
  • Non-weight bearing gastrocnemius and hamstring stretches
  • Sitting assisted flexion hangs
  • Prone leg hangs (for extension)
  • SLR all planes

Functional Training:

  • UBE/ well leg cycling for aerobic conditioning
  • Active/passive jt positioning
  • Balance exercises
  • Stable platform: eyes open & eyes closed
  • Seated ball throwing and catching

PHASE II (2-4 WEEKS):

Goals:

  • Restore normal gait
  • Restore full ROM
  • Improve strength, endurance, & proprioception to prepare for functional activities

Exercises:

  • Mini squats: 0°-30°
  • Stationary bike (start with high seat and low tension)
  • Closed-chain extension: leg press 0°-30°
  • Toe raises
  • Continue stretches & progress to WB gastrocnemius stretches
  • Add weight to prone hangs

Functional Training:

  • Stair training
  • Unstable platform: eyes open & eyes closed
  • Mini-tramp standing
  • Standing ball throwing and catching

PHASE III (6 WEEKS-4 MONTHS):

Goals:

  • Protect joint

Exercises:

  • Advance CKC strengthening:
    • One-leg squats
    • Leg press 0°-60°
  • Stair stepper/elliptical stepper
  • Cross-country skiing machine

Functional Training:

  • Stair jogging
  • Box jumps (6”-12”)
  • Straight ahead jogging: progress to running
  • Figure 8 patterns
  • Large circles: walking or slow jogging
  • Lateral slide board
  • Ball throwing/catching on uneven surface

PHASE IV (MONTH 4):

Goals:

  • Return to unrestricted activities

Exercises:

  • Continue and progress flexibility & strengthening

Functional Training:

  • Agility:
    • Shuttle run
    • Lateral slides
    • Carioca cross-overs
    • Cutting drills
  • Reaction drills
  • Sport specific drills
  • Advance box jump heights

PHASE V (RETURN TO SPORTS):

Goals:

  • Safe return to athletics
  • Maintenance of strength & endurance
  • Patient education concerning any possible limitations

Exercise:

  • Gradual return to sports participation
  • Maintenance program for strength & endurance
  • Agility and sport specific drills progressed

References:
Brotzman SB, Wilk KE. Clinical Orthopaedic Rehabilitation. 2nd ed. Philadelphia, PA: The Curtis Center; 2003.

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